 The Drum Beat – 664 – Polio Communication: Accomplishments, Challenges, Plans |
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| THE MIDDLE EAST |
1. Women’s Activism and the Polio Epidemic in Syria
by Thomas McGee |
| This article explores the participation of women in a 6-round polio vaccination campaign, launched in January 2014 in an effort to vaccinate 2 million children under 5 years of age in Syria’s opposition-controlled areas. Aside from the central humanitarian purpose of the vaccination campaign – to protect children on the «other side» of the frontline – from the wild polio virus (WPV), McGee observes that «the initiative has also served as a powerful means of mobilizing and engaging Syrian women within a context generally perceived to be hostile to female participation.» [Mar 2014] |
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2. Silent Reintroduction of Wild-type Poliovirus to Israel, 2013 – Risk Communication Challenges in an Argumentative Atmosphere
by E Kaliner, J Moran-Gilad, I Grotto, E Somekh, E Kopel, M Gdalevich, E Shimron, Y Amikam, A Leventhal, B Lev, and R Gamzu |
| Israel was certified as polio-free by the World Health Organization (WHO), but, at the end of May 2013, the Ministry of Health (MoH) confirmed the reintroduction of wild-type poliovirus (WPV) 1 into the country. From this report: «The unusual situation in which ongoing poliovirus transmission was picked up through an early warning system of sewage monitoring without active polio cases, brought about significant challenges in risk communication…» The MoH developed a communication strategy that focused on principles such as trust, early announcement, and transparency. Public health professionals who had undergone ad hoc training were mobilised to answer questions, eliminate ambiguity, and rectify disinformation through online and traditional media. The report offers specific lessons learned and questions for reflection (e.g., «Can there be too much information in public health messaging?»). [Feb! 2014] |
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| 3. Strategic Plan for Polio Outbreak Response in the Middle East |
| Communication elements and challenges of this path forward are outlined in the report. With World Health Organization (WHO) and other partners, the United Nations Children’s Fund (UNICEF) indicates that it will support the affected countries to raise awareness of the risks and impact of WPV, the rationale for the vaccines used, and the delivery strategies, as well as to generate community demand for vaccination each time OPV is offered. In addition to the challenge of elevating and sustaining the risk perception of the virus among a population who has not seen polio in over a decade, «[a]mid conflict, distrust among various population groups about the safety of the vaccine is likely to emerge – particularly after the initial wave of response and media attention has waned.» [Nov 2013] |
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| SOUTH ASIA |
| 4. Polio Gallery |
| This video slideshow from CORE Group takes the viewer through the journey of the polio eradication programme in India. The important milestones (e.g., 1999: stiff resistance to the oral polio vaccine (OPV) encountered due to false rumours) and communication strategies (e.g., 2004: religious leaders and institutions «lent their whole hearted support through meetings, appeals, mosque announcements,…etc.») are described in panels, alongside samples of handicrafts created by community members of various districts (e.g., a miniature of the «Polio Chowk», a statue unveiled in Moradabad in 2013 as a tribute to civil society’s contribution toward polio eradication). [Feb 2014] |
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5. Adaptive Macro and Micro Communication Strategies to Eradicate Polio in India: Social Mobilization, Opinion Leadership, and Interpersonal Influence at Unprecedented Scale
by Arvind Singhal |
| Drawing on his experiences with the Global Polio Eradication Initiative (GPEI) in India, Singhal discusses the micro-targeting and messaging interventions designed to achieve large-scale compliance with the oral polio vaccine (OPV), especially in the states of Uttar Pradesh (UP) and Bihar, analysing the elements of social mobilisation, involvement and engagement of local opinion leaders, and a data-driven adaptive strategy. In his conversations with community mobilisers for polio vaccine – mostly women who lived and worked in communities at high risk for ongoing transmission of the polio virus – the author learned that «[w]hat made these on-the-ground social mobilizers tick was the personal rapport, credibility, and trust they brought to an interpersonal encounter….Such personalized, localized interaction with a locally-respected woman, backed by a network of local influencers and opinion leaders, provided an opportunity for iterative dialogue, discussion, and decision-making, leading to the imbibing of the two miracle drops of the oral polio vaccine.» [Jul 2013] |
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| 6. Rotary Club – Polio [Video] |
| «When we join hands, miracles happen.» This is the core message of a Rotary International video marking the achievement of India being declared polio-free in 2014. Rotary, an organisation working for humanitarian services, draws here on the design and creative efforts of Eeksaurus, an Indian organisation working to «weave…stories by combining modern sensibilities to Indian aesthetic traditions.» The script of the video, created by JWT India, is «based on the concept of a young child determined to break free from the bonds that hold him down.» The imagery is meant to communicate «a simple yet effective rendition of how the impossible can be made possible when people join hands in working towards a cause.» The music in the background is sung by children from the slums of Govandi, India. [Apr 2014] |
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7. Monitoring Polio Supplementary Immunization Activities Using an Automated Short Text Messaging System in Karachi, Pakistan
by AM Kazi, A Murtaza, S Khoja, AK Zaidi, and SA Ali |
| For the monitoring of coverage in supplementary immunisation activities (SIAs) carried out as part of the effort to eradicate polio in Pakistan (and, thus, globally), «automated systems based on short message service (SMS) texts appear to be an attractive and relatively inexpensive option.» This is the conclusion of research conducted by Aga Khan University personnel with World Health Organization (WHO) funding. The key message, which researchers say may be useful in other large-scale immunisation campaigns, seems to be that automated SMS-based monitoring «allows for the separation of the vaccine delivery and monitoring teams. It eliminates errors made by human data collectors, reporting bias by field teams – who may exaggerate coverage to improve their apparent performance – and the risk of data collectors being attacked.» [Nov 2013] |
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| 8. Polio Eradication Initiative Afghanistan: Polio Communication Update and Plans |
| In this presentation, prepared as part of a polio Technical Advisory Group (TAG) meeting (November 30 – December 1 2013, Kabul, Afghanistan), the Ministry of Public Health explores, amongst other issues, future strategic communications and programme priorities. For example, one idea is to systematise a plan to track and reach high-risk underserved populations, including nomads and economic and agricultural migrants, with polio-plus communications materials. With regard to mass media and information, education, and communication (IEC), the plan is to generate TV/radio programming/print coverage at the provincial level in local dialect and conduct radio jockey/journalist workshops. Another goal is to expand IEC materials for illiterate populations that, for example, integrate basic routine immunisation (RI) messages into existing polio communication materials. With regard to monitoring and evaluation (M&E), one idea going forward is to streamline data sharing within the polio partnership at all levels for rapid analysis and action. |
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| 9. Sanitation and Hygiene Advocacy and Communication Strategy Framework 2012-2017 |
| This document describes a consultative process in India to create a framework to guide the execution of advocacy and communication efforts related to toilet construction and use and key critical sanitation and hygiene behaviours at the national, state, and district levels. Noting that converting dry latrines was an urgent priority in elimination of transmission of wild polio virus (WPV) in Budaun, as part of one phase of the 3-phase communication strategy, Polio’s Social Mobilisation Network, block and village level motivators, and village pradhans used interpersonal communication in an effort to raise awareness of the purpose of the initiative, the need for the initiative, and the associated health hazards. They explained the technology of the new toilets and addressed the concerns of the community. |
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| AFRICA |
| 10. Operation Zero Cases: A Tailored Approach to Polio Prevention |
| This film shares how information gathered from families in previous campaigns helped teams increase the number of children vaccinated against polio in Chad. It sheds light on good practices in terms of the use of collected data for the planning of communication activities in urban environments and on various other aspects of social mobilisation efforts. The film also provides a closer look at the work being undertaken by communication for development practitioners and frontline workers. [UNICEF, Feb 2014] |
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11. Key Issues in the Persistence of Poliomyelitis in Nigeria: A Case-Control Study
by Dr Tara D Mangal PhD, R Bruce Aylward MD, Michael Mwanza BComm, Emmanuel Abanida MBChB, Muhammed A Pate MD, and Nicholas C Grassly PhD |
| In Nigeria, poliomyelitis cases doubled between 2011 and 2012. The question this study seeks to explore is: Why has Nigeria has been experiencing continued high caseloads despite having achieved «record successes in vaccine coverage and political and community engagement»? The main reported reasons for missing routine OPV doses in 2012 were an ignorance of vaccine importance or vaccine availability. One section of the paper focuses on the principal reason for children with poliomyelitis to miss RIs, which researchers found to be tied to «an ignorance of its importance, reaffirming the recommendations made by the Independent Monitoring Board of the Global Polio Eradication Initiative that promotion of demand generation is vital to eradication.» [Feb 2014] |
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12. The Impact of Polio Eradication on Routine Immunization and Primary Health Care: A Mixed-Methods Study
by Svea Closser, Kelly Cox, Thomas M. Parris, R. Matthew Landis, Judith Justice, Ranjani Gopinath Kenneth Maes, Hailom Banteyerga Amaha, Ismaila Zango Mohammed, Aminu Mohammed Dukku, Patricia A. Omidian, Emma Varley, Pauley Tedoff, Adam D. Koon, Laetitia Nyirazinyoye, Matthew A. Luck, W. Frank Pont Jr, Vanessa Neergheen, Anat Rosenthal, Peter Nsubuga, Naveen Thacker, Rashid Jooma, and Elizabeth Nuttall |
| In order to assess the impact of polio eradication (PE) activities on RI and primary health care (PHC), researchers evaluated the effects of (i) the initial scale-up of PE activities and (ii) the number of polio vaccination campaigns per year on measures of RI and PHC via 8 district-level case studies in 7 countries in Africa and South Asia. The quantitative analysis did not find compelling evidence of widespread and significant effects of PE campaigns, either positive or negative, on measures of RI and maternal health care. The qualitative analysis revealed context-specific positive impacts of PE activities in many of the case studies. For example: «Public awareness of vaccination and health services had increased markedly in the past 15 years in many of our case studies. Polio eradication activities made some contributions to this increase in awareness but were not the only or primary contributing factor in any case study.» [Apr 2014] |
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| GLOBAL |
13. Culture and Behaviour in Mass Health Interventions: Lessons from the Global Polio Eradication Initiative
by Sebastian A.J. Taylor |
| «Interpreting resistance to vaccination as essentially religio-cultural marginalises an understanding of resistance as the rational and strategic response by households and communities to systematic conditions of inequity and exclusion.» This is the central thesis advanced in this paper, which draws on a desk-based review of literature, real-time epidemiological evidence, and the author’s own field-based experience working with the Global Polio Eradication Initiative (GPEI) over periods since 2001. |
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| 14. Silent Reintroduction of Wild-type Poliovirus to Israel, 2013 – Risk Communication Challenges in an Argumentative Atmosphere |
| From blogger Seye Abimbola: «We do need to retreat a little in our battle against polio, to remove the layers of established thought from the lenses through which the global health community views polio eradication. We need to retreat for the purpose of building trust, take a rest from international deadlines to eradicate the disease, and in the meantime focus energies and resources on strengthening routine immunisation and other primary health care services. We need to change our rhetoric to one which prioritises making polio eradication part of the routine health system rather than highlighting it as ‘the only’ health problem and put the people first, be they health workers or communities benefiting from health interventions. Polio eradication will only be achieved with stronger health systems and bottom-up community engagement, which will likely require more time and investment than the newly ! designated deadline to eradicate polio in 2018 affords.» [Mar 2014] |
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| 15. Global Vaccine Action Plan 2011-2020 |
| Developed through a collaborative process, the Global Vaccine Action Plan (GVAP) is a framework to achieve the Decade of Vaccines (DoV) vision by delivering universal access to immunisation prior to 2020 and beyond. The reader learns that: «The immunization community can take advantage of social networks and electronic media to more effectively allay fears, increase awareness and build trust.» The report proceeds to outline the GVAP guiding principles, measures of success, and goals of the DoV. Six strategic objectives are articulated, with sample suggestions such as: «The participation of in-country civil society organizations will be crucial to develop strong advocacy efforts and should be supported by capacity building. Here again, an effort that promotes collaboration between evidence generators and evidence users could provide training for champions and link with local social and professiona! l networks, which are an important source of grass-roots immunization champions.» [Mar 2013] |
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| See also these recent issues of The Drum Beat focused on polio communication: |
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| This issue of The Drum Beat was written by Kier Olsen DeVries. |
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| The Drum Beat is the email and web network of The Communication Initiative Partnership – Partners: ANDI, BBC Media Action, Bernard van Leer Foundation, Breakthrough, Calandria, DFID, FAO, Fundación Nuevo Periodismo Iberoamericano (FNPI), Inter-American Development Bank, Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, MISA, Oxfam Novib, PAHO, The Panos Institute, Puntos de Encuentro, The Rockefeller Foundation, SAfAIDS, Sesame Workshop, Soul City, STEPS International, UNAIDS, UNDP, UNICEF, USAID, The Wellcome Trust, World Health Organization (WHO), W.K. Kellogg Foundation.
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Chair of the Partners Group: Garth Japhet, Founder, Soul City garth@heartlines.org.za
Executive Director: Warren Feek wfeek@comminit.com |
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| The Editor of The Drum Beat is Kier Olsen DeVries. |
| Please send additional project, evaluation, strategic thinking, and materials information on communication for development at any time. Send todrumbeat@comminit.com
The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.
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